Chronic ulcerative dermatitis with furunculosis in a cat

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Rach — Mon, 01 Nov 2010 20:48:59 GMT

C&S results were moderate growth of S.intermedius, sens to amoxyclav and cephalexine, so a little confused as to what has sparked the reaction. Cat is now on rilexine anyway and have started it on pred. To reply to some of the questions/comments, I didn't send off the excised lesions, didn't percieve a need at the time and cat is not insured, ditto sending to more than one lab. Also haven't done mycobacterial or fungal culture for the same reasons, but may have to... Thank you all for your comments and suggestions, they are all really appreciated, I'll let you know how it goes on preds.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Mark Hedberg — Sun, 31 Oct 2010 09:02:55 GMT

Megestrol acetate is also helpful in non healing wounds but must be given for months. Cat should be neutered, though.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Richard Fox — Thu, 28 Oct 2010 16:15:48 GMT

What about plasmacytic pododermatitis. I can be limited to one foot/pad sometimes - just a thought :)

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Jillian Hall — Thu, 28 Oct 2010 13:12:43 GMT

I've just biopsed a very similar looking lesion about 20 minutes ago. A non healing wound on a foot of a 5yo cat with underunning and dehiscence of most of the main pad, mascerated interdigital skin with several small sinus tracts and lots of pus despite 3 weeks of antibiotics. (C+S results are pending). I'll wait for the Bx results then perhaps the cat would like some pred.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Martin Atkinson — Thu, 28 Oct 2010 09:35:33 GMT

These can be very frustrating to treat, does the cat have lesions anywhere else on the body that may indicate a more general allergic dermatitis especially as you say it is over-grooming? I would have given steroids (preds not depomed - seen too many side effects even in cats) to shrink the lesion then surgery to excise the last remnants so the surgical wound was minimised. Provided any secondary infection is correctly identified and treated appropriately it should heal but some of these do recurr and will require continued or intermittent steroid therapy. I've had success with cyclosporine in some that won't respond to steroids alone but although most cats do very well with it, it is playing with fire and very informed consent is required. However, are you sure of the histopathology? You can send inflammatory tissue samples to 5 different histopathologists and get 5 different interpretations. I would also have sent the excised tissue for histo but if it wont heal I'd re-excise the non-healing tissue and send that to a diifferent lab.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Andrew Mellor — Thu, 28 Oct 2010 09:04:40 GMT

I may get slated for this, but I have given steroids in such cases. The wound will take longer to heal, but it still will. If it's over the hock it's not a critical wound. I wouldn't give steroids if you'd been through into the abdomen. Should be ok with suitable antibiotics based on the C&S.

I would have tried depo before removing it.

I would entirely agree , cats do brilliantly with depo, and seem to tolerate it extremely well, I would also say having had a few difficult ones like this myself i have used convenia rather than oral cephalexin with seeming much better response as levels remain so high.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Camilla Edwards — Thu, 28 Oct 2010 08:17:14 GMT

I don't have much to add, just that I have heard of a case similar to this which turned out to be Mycobacteria,

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Christopher Saul — Wed, 27 Oct 2010 23:25:48 GMT

I think in general your case management has been fine; you really need your c and s results, and give a good long course of appropriate antibiiotics. I would just second Mark's point that histology of the excised lesion would be useful.

One thought; have you requested a ZN stain on the histo samples? Mycobacterial infections are not common, but I always have them in the back of my mind when thinking about non-healing lesions in cats

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Mark Holmes — Wed, 27 Oct 2010 23:07:20 GMT

Did you submit the excised leison for histology? I appreciate you took a biopsy but I wonder if the biopsy was representative? Some times deep tissue can vary from superficial tissue. Could your margins have been a little tight at the non healing end? Any history of repeat trauma to elbow? Pressure sore? Also concurrent dz? Thyroid, diabetes, hyper A etc?

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Michael Woodhouse — Wed, 27 Oct 2010 22:48:10 GMT

[quote user="Rach"]

even in what is now a full skin thickness wound, will it not slow wound healing further?

[/quote]

I would have tried depo before removing it.

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Rach — Wed, 27 Oct 2010 22:31:35 GMT

even in what is now a full skin thickness wound, will it not slow wound healing further?

Re: Chronic ulcerative dermatitis with furunculosis in a cat

Michael Woodhouse — Wed, 27 Oct 2010 22:01:05 GMT

Don't be afraid of steroids. Depomedrone is magic in cats. They tolerate them so much better than dogs.